Free community service form 12
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COMMUNITY SERVICE FORM | Verification
[VERIFICATION OF THIS COMMUNITY SERVICE FORM TO BE COMPLETED BY THE FUND RECIPIENT]

Applicant name ..................................................................................................................................................
(Name(s) of group or individual)

Project Title

..................................................................................................................................................
(Title or name if applicable)

Contact person ..................................................................................................................................................
(If applicable)

[TO BE COMPLETED BY COMMUNITY ORGANIZATION/GROUP/ELDER]

BRIEF DESCRIPTION OF VOLUNTEER ACTIVITY:
......................................................................................................................................................................
............................................